classificazione sindromi coronariche acute acc/aha/esc

59 Pages·2010·7.6 MB·English

UPDATE SU SINDROMI CORONARICHE ACUTE
CLASSIFICAZIONE
SINDROMI CORONARICHE
ACUTE ACC/AHA/ESC
Antonino Stipo
UOC Emodinamica e Cardiologia Interventistica
Ospedale “S. Maria Goretti”-Latina
Aprilia 4-XII-2010 Clinica “Città di Aprilia”
AAnnggiinnaa iinn ccrreesscceennddoo
I mnfiaorctaor dmiciooc Ianrfdairctoo aaccuuttoo Necrosi
parcellare
STEMI
Infarto nonQ
Infarto subendocardico
Angor protratto Angina instabile
Quale diagnosi?
Quale terapia?
Angina instabilizzante IInnffaarrttoo rruuddiimmeennttaallee
Infarto misconosciuto
Angina a frigore Angina ricorrente
NSTEMI
Infarto transmurale
Cardiovascular diseases are presently the
leading causes of death in industrialized
countries and expected to become so in
emerging countries by 2020.
Murray CJ, Lopez AD. Alternative projections of mortality and disability by
cause 1990–2020: Global Burden of Disease Study. Lancet 1997;349: 1498–1504
Among these,
coronary artery disease (CAD)
is the most prevalent manifestation
and is associated with high mortality
and morbidity.
Coronary atherosclerosis (CAD) is a chronic
disease
with stable and unstable periods.
During unstable periods with activated
inflammation in the vascular wall,
patients may develop a myocardial infarction.
Myocardial infarction may be a minor event in a lifelong
chronic disease,
it may even go undetected,
but it may also be a major catastrophic event leading
to sudden death or severe haemodynamic deterioration.
A myocardial infarction may be the first manifestation
of coronary artery disease,
or it may occur, repeatedly, in patients with established
disease.
CCoorroonnaarryy AArrtteerryy DDiisseeaassee ((CCAADD))
IIsscchhaaeemmiicc HHeeaarrtt DDiisseeaassee ((IIHHDD))
IIsscchhaaeemmiicc HHeeaarrtt DDiisseeaassee ((IIHHDD))
CClliinniiccaall PPrreesseennttaattiioonnss
Silent Ischaemia

Stable Angina Pectoris

Unstable Angina

Myocardial Infarction

Heart Failure

Sudden Death

ESC Guidelines NSTE SCA 2007
Task Force Report
Task force on the management of chest pain European Heart Journal (2002) 23, 1153–1176
AAccuuttee CCoorroonnaarryy SSyynnddrroommeess::
iinniittiiaall aasssseessssmmeenntt

ESC Guidelines European Heart Journal (2007) 28, 1598–1660